Hyperuricemia Associated with Thiazide Diuretics in Hypertensive Adults

Raja, Ravi; Kavita, Fnu; Amreek, Fnu; Shah, Ali A.; Sayeed, Khalid A; Sehar, Alina

doi:10.7759/cureus.5457

Cited by 16 publications

(14 citation statements)

References 12 publications

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“…Also, subjects who took anti-hypertensive medication have significantly associated with hyperuricemia in which the likely hood of developing hyperuricemia were 11.56 higher in participants with medication when compared with counterparts. This was in line with studies conducted in Tunisia, Seychelles and Pakistan [19,29,30]. The association might be dues to the fact that medications especially diuretics, angiotensin converting enzyme inhibitors and beta-…”

Section: Plos Onesupporting

confidence: 90%

“…However, despite achieving adequate control a rise in blood pressure, these drugs are also associated with adverse events like hyperuricemia. Diuretics, beta-blockers and angiotensin converting enzyme inhibitors are associated with elevated serum uric acid by increasing direct urate reabsorption in the proximal renal tubules and by inhibited basolateral organic anion transporters and by reducing glomerular filtration rate [5,29]. The current study also showed that higher BMI and being centrally obese had significantly associated with hyperuricemia (AOR: 11.56, 95%CI: (3.94, 23.80)) and (AOR: 6.87, 95%CI: (2.53, 18.63)) respectively.…”

Section: Plos Onementioning

confidence: 99%

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Evaluation of uric acid disorders and associated factors in essential hypertensive patients at Wolkite University specialized hospital, Southern Ethiopia

Timerga

Haile

2021

PLoS ONE

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Background Essential hypertension is a condition characterized by a rise in blood pressure of undetermined cause, includes 90% of all hypertensive cases and is a highly important public health challenge with major modifiable cause of morbidity and mortality. Uric acids disorders in particular hyperuricemia are significant problems in essential hypertensive patients and can cause substantial morbidity and mortality. Determination of uric acid disorders may play a major role in the management and early aversion of complications in hypertensive patient. Therefore, this study aimed to determine uric acid disorders and associated factors among essential hypertensive adults in the outpatient department at Wolkite University specialized Hospital, Southern Ethiopia from November 1 to February 30, 2021. Methods and materials An institional based cross sectional study was conducted on 270 essential hypertensive adults on follow-up in outpatient department from November 1 to February 30, 2021. Structured questionnaires through face to face interviews and participants’ medical records were used to collect information on determinants related with uric acid disorders. The blood specimen was collected and level of serum uric acid, blood sugar and lipid profile was measured using standard principles and procedures with an ABX Pentra 400 automated chemistry analyzer. Bivariate and multivariate logistic regression analyses were done to identify factors associated with hyperuricemia. The p-value was set at <0.05 with a 95% confidence interval of the adjusted odds ratio. Results A total of 270 adult essential hypertensive patients were participated in the study, among those 196(27.4%) of study participants were hyperuricemic with 95%CI (21.9, 33.3). Being alcoholic [(AOR: 15.68, 95% CI: (5.93, 21.41)], taking antihypertensive medication [(AOR: 11.56, 95% CI: (3.94, 23.80)], BMI > = 30 [(AOR: 4.89, 95% CI: (1.46, 25.5)] and being centrally obese [(AOR: 6.87, 95% CI: (2.53, 18.63)] were factors significantly associated with hyperuricemia. Conclusion In this study, the high burden of hyperuricemia (27.4%) was observed in essential hypertensive patients with follow-up in outpatient department. Taking alcohol and antihypertensive medication, being overweight and centrally obese were identified factors of uric acid disorders. The finding of this study should be taken into consideration to implement preventive interventions on identified predictors in hypertensive patients. Taking fruit and vegetable, and promoting physical exercise and determinations of serum uric acid level in adult essential hypertensive patients was recommended to minimize the emergence of hyperuricemia.

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Section: Plos Onesupporting

confidence: 90%

Section: Plos Onementioning

confidence: 99%

Evaluation of uric acid disorders and associated factors in essential hypertensive patients at Wolkite University specialized hospital, Southern Ethiopia

Timerga

Haile

2021

PLoS ONE

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“…It is important to note that certain hypertension medications such as thiazide diuretics have been shown to increase uric acid concentrations. 18…”

Section: Discussionmentioning

confidence: 99%

Treatment of Acute Gout Flares in the Emergency Department: Prescribing Patterns and Revisit Rates

et al. 2021

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Background The incidence and health care costs of gout flares have increased in the United States. The increased costs may be a result of a lack of adherence to treatment guidelines and medication knowledge. Identifying causes for this trend is vital to mitigate inappropriate resource use. Objectives The aim was to identify pharmacotherapy use related to gout treatment before, during hospital visit or stay, and on discharge in patients presenting to the emergency department (ED) with gout flares. Secondary end points included opioid use, revisit rates, and associated risk factors. Methods We performed a retrospective cohort study at a community teaching hospital ED. All consecutive patients visiting the ED from January 2016 to July 2019 with a primary diagnosis of gout flare were included. Data were extracted from the electronic medical records. Results The analysis included 214 patients. Anti-inflammatory medication was not prescribed in 33.6% during the hospital visit and 29.6% of patients on discharge. History of opioid use (odds ratio [OR] = 3.3; 95% CI = 1.3-8.6; P = 0.014) and gastroesophageal reflux disease (OR = 3.5; 95% CI = 1.09-10.9; P = 0.035) were associated with opioid prescription on discharge. ED revisits within 90 days for any gout-related or non–gout-related cause were recorded in 16.8% of patients. Conclusion and Relevance Roughly 30% of patients did not receive an anti-inflammatory on discharge, and opioids were frequently overused in gout management in the ED. There is an opportunity for further education of health care providers regarding gout treatment.

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“…Indeed, thiazide diuretics are frequently used in geriatric patients with hypertension (7). However, thiazide diuretics are known to cause SUA elevation (8). The correlation between the Mini Mental State Examination (MMSE) and SUA has been studied previously, but the results have been contradictory (9).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Thiazide and Thiazide-Like Diuretics on the Relationship Between Normal Serum Uric Acid Levels and Cognitive Function

Koçak¹

2021

tjgeri

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The objective of this study was to identify the possible effect of thiazide and thiazide-like diuretic use on the relationship between uric acid and cognitive function in geriatric patients with normal renal function.Method: Serum uric acid levels and Mini-Mental State Examination scores of 238 patients (age ≥65 years) treated in an outpatient geriatric clinic were evaluated in this observational, cross-sectional, retrospective study. The effect of thiazide diuretic use on Mini-Mental State Examination score was also assessed.Results: Compared to patients that are not currently taking thiazide diuretics (non-thiazide group) serum uric acid was significantly higher in patients using thiazide and thiazide-like diuretics (thiazide group) (5.27±0.12 vs 6.09±0.20; P< 0.001). Although the serum uric acid levels were higher in the thiazide group the Mini-Mental State Examination scores were similar to the non-thiazide group. There was a strong positive correlation between serum uric acid levels and Mini-Mental State Examination score in both groups (P< 0.001). The Mini-Mental State Examination score was significantly lower in the lowest serum uric acid quartile in both groups (P< 0.001).Conclusions: Low serum uric acid levels are associated with cognitive impairment; a slight but significant increase of serum uric acid due to thiazide diuretic use does not seem to enhance cognitive function in geriatric patients.

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Hyperuricemia Associated with Thiazide Diuretics in Hypertensive Adults

Cited by 16 publications

References 12 publications

Evaluation of uric acid disorders and associated factors in essential hypertensive patients at Wolkite University specialized hospital, Southern Ethiopia

Evaluation of uric acid disorders and associated factors in essential hypertensive patients at Wolkite University specialized hospital, Southern Ethiopia

Treatment of Acute Gout Flares in the Emergency Department: Prescribing Patterns and Revisit Rates

The Effects of Thiazide and Thiazide-Like Diuretics on the Relationship Between Normal Serum Uric Acid Levels and Cognitive Function

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